Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report.

BACKGROUND: Gallbladder perforation is a rare clinical condition, which mostly occurs following acute cholecystitis associated with cholelithiasis. A tumor of the ampulla of Vater causes gradually progressive symptoms, and is rarely associated with perforation of the gallbladder. CASE PRESENTATION: A 56-year-old man with carcinoma of the ampulla of Vater presented with spontaneous gallbladder perforation and localized bile peritonitis. He complained of right upper abdominal pain, and laparotomy revealed perforation of the gallbladder with no gallstones. Postoperative upper gastrointestinal endoscopy demonstrated a slightly enlarged duodenal papilla, and biopsy revealed adenocarcinoma of the ampulla. Pylorus-preserving pancreaticoduodenectomy was performed subsequently. CONCLUSION: Ampullary carcinoma can be associated with gallbladder perforation and present with acute manifestations. Immediate surgical treatment is required for this condition.

Retroperitoneal mixed-type liposarcoma showing features of four different subtypes.

Mixed-type liposarcoma is a rare soft tissue tumor. This report describes a 50-year-old man with retroperitoneal mixed-type liposarcoma that consisted of four pathologically different components. Preoperative CT and MRI showed a giant retroperitoneal mass composed of several nodules with various attenuation and signal intensity. At laparotomy, the tumor appeared to be composed of four components. Pathologic examination revealed that each component was of a histologically different subtype. Mixed-type liposarcoma containing four different subtypes is extremely rare. Its clinical and pathologic features are briefly reviewed.

Pseudomyxoma peritonei presenting with femoral hernias and peritonitis.

Pseudomyxoma peritonei is a rare disease characterized by intraperitoneal accumulation of mucinous ascites produced by neoplastic cells, which mostly originate from an appendiceal adenoma. The clinical presentation of the disease varies, and preoperative diagnosis is often difficult. This report describes a 76-year-old female patient with pseudomyxoma peritonei who presented with lower abdominal pain and bilateral femoral masses. Computed tomography revealed bilateral femoral hernias and fluid collection in the peritoneal cavity. Laparotomy was performed, during which we found extensive diffuse gelatinous material mixed with purulent ascites, and the diagnosis of pseudomyxoma peritonei was confirmed. The disease is rarely associated with femoral hernias or peritonitis. Its clinical presentation, including the characteristic findings on computed tomography, and surgical management are briefly reviewed.

[A case of multiple hepatic and peritoneal metastases from colon cancer responding to oral UFT+leucovorin chemotherapy].

A 57-year-old woman underwent right hemicolectomy (D3) due to transverse colon cancer with multiple liver and peritoneal metastasis. Administration of oral UFT+Leucovorin was started postoperatively. After 6 months, the multiple liver metastases completely disappeared without any adverse reaction. After 14 months, no other recurrence was found by CT scan. This case suggests the usefulness of oral UFT+Leucovorin for progressive recurrent colorectal cancer as home chemotherapy.